Provider Demographics
NPI:1447398417
Name:MELCO, PATRICIA ANNE
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:MELCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:SKARDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1366 WESTMINISTER STREET
Mailing Address - Street 2:APT #105B
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-3344
Mailing Address - Country:US
Mailing Address - Phone:651-771-1891
Mailing Address - Fax:
Practice Address - Street 1:2200 UNIVERSITY AVE
Practice Address - Street 2:INTERIM HEALTH CARE SUITE #160
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114
Practice Address - Country:US
Practice Address - Phone:651-917-3634
Practice Address - Fax:651-917-3620
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health